The C-word is one that strikes much fear and worry, and the rise in cases in Malaysia itself is much cause for concern – about 49,000 people in Malaysia were estimated to be newly diagnosed with cancer in 2020, with the figure expected to increase to 66,000 new cases annually by 2030. Breast cancer cases are also expected to see a 49% jump from 2012 to 2025, and Malaysia having a much lower five-year survival rate at only 63% – South Korea stands at 92% and Singapore, 80% – it is something that we all need to stand up and pay attention to.
In the health community, October is designated as breast health awareness month, and Sunway Medical Centre Velocity (SMCV) is taking this opportunity to join the conversation as well as raise awareness surrounding ovarian cancer which is also known for its difficulty to be detected early. By doing so, SMCV hopes to assist women in understanding their breast and gynaecological health better to rule out potential health issues and get the necessary treatment as early as possible to stand a better chance at recovery.
Keeping abreast of changes in your body
Dr Suziah Mokhtar, Consultant Breast, Endocrine and General Surgeon from SMCV shares that the overall lifetime risk of getting breast cancer is one in 27 women – and this probability increases if they have a first degree relative (mother, sister, daughter) or multiple family members who have had breast or ovarian cancer.
“Most breast cancers are sporadic where the cancer develops from gene damage that occurs by chance in adulthood. There is no risk of passing these genes onto their children. Inherited cancer only makes up 5-10% of all breast cancers and occurs when gene mutations or alterations such as BRCA1, BRCA2 and PALB2 are passed down from parent to child. The underlying cause is multifactorial and is usually the result of a combination of internal physiology, hormonal, lifestyle and environmental factors,” she shares.
Some of the more common types of breast cancer are invasive, which have the ability to spread, and in-situ, which are localised in its place of origin. Majority of breast cancers arise from the milk duct, with invasive ductal carcinoma being the most common – accounting for 70-80% breast cancers. “Breast lump is the most common presenting symptom among woman with breast cancer, followed by nipple abnormalities and breast pain. Lesser known symptoms include lumps in the armpit (usually mistaken as a normal lymph node), skin changes (usually mistaken for eczema or allergy) or symptoms related to cancer spreading to other organs such as to the lung causing coughing or shortness of breath; to the liver leading to jaundice, ascites and to the brain causing persistent headaches,” Dr Suziah adds.
Thankfully, early detection of breast cancer can result in a better outcome. Mammogram, the most common screening test for breast cancer in women above the age of 40 have led to a reduction of almost 20% in deaths from breast cancer. For younger women, ultrasound screening can be conducted, and women with a higher risk of developing breast cancer should consider it from the age of 30. Dr Suziah notes that treatment is always individualized, which includes surgery, chemotherapy, radiotherapy, endocrine therapy and targeted therapy.
“The earlier the breast cancer is diagnosed, the better the chance of a successful treatment. It is important to check your breasts regularly. It is easier to spot anything unusual in one’s breast if the person knows how her breasts normally look and feel,” Dr Suziah stresses.
Importance of female health education
In 2020, the International Agency for Research of Cancer (IARC) found that there were 1836 new cases of ovarian cancer in Malaysia, making it the third most frequent malignancy diagnosed in females after breast and colorectal cancer. Ovarian cancer peaks at the age of 60-65 years with more than 50% being diagnosed at stage 3 or 4 of the disease.
Dr Wong Yen Shi, Consultant Obstetrician and Gynaecologist from SMCV explains that only about 20% of ovarian cancers are detected at an early stage, as there has yet to be a screening or test developed to screen for early treatment. “As for now, the transvaginal scan and CA 125 tumour marker test are used to detect it, but with limitations. The former can detect masses, but it can be difficult to differentiate a benign tumour from a malignant one, whereas the latter is a good test to monitor treatment but not for screening purposes.
“Ovarian cancer symptoms include bloating, abdominal discomfort, urinary frequency, constipation, feeling full quickly, loss of weight, fatigue and back pain. This cancer can be mistaken for benign ovarian tumours, uterine fibroids, endometriosis and premenstrual syndromes,” she notes.
While it is a challenge to detect ovarian cancer, Dr Wong shares that there are risk factors one can look out for, which includes having a family history of breast, ovarian and colorectal cancers, familial cancer syndromes such as BRCA genes and Lynch syndromes as well as increase in age and being overweight or obese. Others include smoking, exposure to asbestos, women undergoing hormone replacement therapy (HRT), nulliparous (never given birth to a child), having children at a later age, early menstrual and late menopause.
“Routine medical check-ups and preventive screenings for diabetes, cholesterol, cardiac health and breast and cervical screenings should be done. It is important to eat healthy and exercise regularly – managing your mental health, getting sufficient sleep and managing stress is also a good way to take care of your health as a whole,” she says.
The rise in cancer statistics is a crucial sign that women should be mindful of their health and prioritise it along with their families. Health is paramount to overall wellbeing and concerned individuals should reach out to their healthcare providers for further insights into their own conditions so they can take care of themselves first.
In conjunction with Breast Cancer Awareness Month this October, apart from providing breast cancer screening and other female health screening packages, SMCV is taking part in Sunway Healthcare Group’s campaign in providing free mammogram screenings for eligible patients, freebies giveaway and collaboration with a female-centred brand for a community engagement event with hopes that this will spark greater conversation amongst women and provide them with the opportunity to be in control of their health.